It was interesting to read how much of the US drugs market relies on imports. The article deals with the high value stuff. However, by volume, 90% of drugs used in the US are cheaper generics often with no US manufacturers. The US is heavily reliant on India and ultimately China for both active pharmaceutical ingredients and key starting materials. With 80% of Indian production using starting materials from China.[0]

The US had no domestic production of penicillin between 2004[3] when its last plant shuttered until 2021 when a factory reopened.[1] (source 1 and 3 appear to contradict, the 2019 testimony states there was no manufacturer after 2004 whereas it sounds like the plant closed in 2020, regardless the domestic capability is extremely weak)

As usual for American sources this is painted as some nefarious scheme by the evil red Chinese to destroy America by making cheaper drugs available. To add my own editorialising I think US companies are easily capable of ruining US manufacturing and focusing on screwing US patients over.[2] The average citizen should probably be glad of low cost Chinese supply, but nurturing domestic capability as per Biden is sensible.

[0]: https://prosperousamerica.org/skyrocketing-pharmaceutical-im...

[1]: https://www.fiercepharma.com/manufacturing/reopening-penicil...

[2]: https://www.rand.org/news/press/2024/02/01/index1.html

[3]: https://www.uscc.gov/sites/default/files/RosemaryGibsonTesti...

[4]: sources per https://youtu.be/hS0-ugYA-ko?si=xCNzctCGr9f2M7ct